Melissa Ruth Larsen, M.D.

Primary specialty

Plastic and Reconstructive Surgery PhysicianTaxonomy code 2086S0122X

License

MD61185777 Issued in WA

Practice address

209 Martin Luther King Jr Way
Tacoma, WA 98405-4265

Phone

(253) 596-3300

Fax

(253) 596-3301

NPI assigned

Mar 30, 2015

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other names 1

• Melissa Ruth Symon Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in WA

Opted out of Medicare

Yes, effective May 2, 2026 through May 2, 2028

Enrollment records 1

Specialty

Plastic and Reconstructive Surgery

Education

Creighton University School of Medicine, 2015

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: msymon2947549@ghc.direct-ci.net

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Blackburn & Whitney MD PS

  • Specialist
  • Bellingham, WA
  • NPI 1144374919
  Medicare reassignment NPD
• Kaiser Foundation Health Plan of Washington

  • Multi-Specialty Clinic/Center
  • Seattle, WA
  • NPI 1396810701
  Medicare reassignment NPD
• Nordhavn Plastic Surgery, PLLC

  • Plastic and Reconstructive Surgery Physician
  • Gig Harbor, WA
  • NPI 1871465666
  NPD Authorized official
• Blackburn & Whitney MD PS

  • Ambulatory Surgical Clinic/Center
  • Bellingham, WA
  • NPI 1881184356
  NPD
• Kaiser Foundation Health Plan of Washington

  • Multi-Specialty Clinic/Center
  • Renton, WA
  • NPI 1124264577
  NPD
• Kaiser Foundation Health Plan of Washington

  • Multi-Specialty Clinic/Center
  • Everett, WA
  • NPI 1386935351
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1427673600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675123200000",
    "number": "1386039154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "209 MARTIN LUTHER KING JR WAY",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984054267",
            "telephone_number": "253-596-3300",
            "fax_number": "253-596-3301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "209 MARTIN LUTHER KING JR WAY",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984054265",
            "telephone_number": "253-596-3300",
            "fax_number": "253-596-3301"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2500 Squalicum Pkwy Bldg 102",
            "address_purpose": "LOCATION",
            "city": "Bellingham",
            "state": "WA",
            "postal_code": "982251856",
            "country_code": "US",
            "telephone_number": "360-676-0972",
            "fax_number": "360-671-4423",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LARSEN",
        "first_name": "MELISSA",
        "middle_name": "RUTH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-03-30",
        "last_updated": "2023-01-31",
        "certification_date": "2023-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0122X",
            "taxonomy_group": "",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "WA",
            "license": "MD61185777",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwa.kp.org:14430/Interconnect-CE-PRD/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "209 Martin Luther King Jr Way",
            "city": "Tacoma",
            "state": "WA",
            "country_code": "US",
            "postal_code": "984054265",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "MELISSA",
            "last_name": "SYMON",
            "middle_name": "RUTH",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Bennett Packard Larsen, DDS
• Bjorn E Larsen, P.A.
• Charlee Larsen
• Christine J. Larsen, ARNP
• Jack Gregory Larsen
• Nancy Louise Larsen
• Rachael A Larsen, LM
• Rosanne M. Larsen, M.D.
• Acacia N. Larson
• Alyssa Larson

• Plastic and Reconstructive Surgery Physician in Tacoma, WA
• Providers in Tacoma, WA by specialty
• Plastic and Reconstructive Surgery Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.